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Defeat Diabetes Foundation

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Diabetes Sufferers Prefer Oral Management

Posted: Tuesday, April 25, 2006

A major international study has shown that many people with type-2 diabetes are not achieving optimal blood sugar control despite the availability of effective treatments It found that 64 per cent of people who had had type-2 diabetes for more than 10 years were still not achieving optimum blood sugar levels. Although insulin remains the most effective course of action, it appears that many sufferers are put off using it because of the necessity for injections.

Results of a new study, suggest that there is a high prevalence of prehypertension in both diabetic and non-diabetic subjects. Also, prehypertension is associated with higher risks of cardiovascular disease in both populations.

"There are few data about the impact of the recently-defined category of prehypertension (systolic blood pressure 120 to 139 mm Hg or diastolic blood pressure 80 to 89 mm Hg) on cardiovascular disease incidence," Dr. Ying Zhang, of the University of Oklahoma Health Sciences Center, Oklahoma City, and colleagues write. "It is also unknown whether this association differs between individuals with or without diabetes."

The researchers examined the prevalence of prehypertension in 2629 subjects enrolled in the Strong Heart Study, a population with a high prevalence of diabetes. They also assessed hazard ratios for cardiovascular disease with prehypertension in patients with and without diabetes. The participants were free from hypertension and cardiovascular disease at baseline and were followed for 12 years for incident cardiovascular disease. Approximately 42% had diabetes.

There were a total of 389 incident cardiovascular disease events during follow-up. The lowest cumulative incidence was found in nondiabetic patients with normal blood pressure.

Compared with nondiabetic normotensive subjects, the hazard ratio of cardiovascular disease for those with diabetes and prehypertension was 3.70. For those with diabetes alone or with prehypertension alone, the hazard ratios were 2.90 and 1.80, respectively. The risk of cardiovascular disease in prehypertensive subjects was greatly increased with impaired fasting glucose and impaired glucose tolerance.

"The magnitude of the increased cardiovascular disease risk related to the coexistence of prehypertension, glucose intolerance, and diabetes suggest that pharmacological intervention for blood pressure control in these groups may be warranted to prevent cardiovascular disease morbidity and mortality, as suggested by others," Dr. Zhang's team concludes. "A clinical trial is needed to confirm this."

Source: Diabetes In Control